一种新型虚拟回肠造瘘保护装置在家兔体内的实验研究  

Experimental investigation of a new protective device of virtual ileostomy in rabbits

作　　者：时林森[1] 李超[1] 孟松[1] 王辉[1] 韩亚东[1] 朱孝成[1] 管文贤[2] 

机构地区：[1]徐州医学院附属医院胃肠外科,221006 [2]南京大学附属鼓楼医院胃肠外科,210008

出　　处：《中华普外科手术学杂志（电子版）》2015年第5期60-63,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：徐州市科技计划项目(KC14SH118)~~

摘　　要：目的研究一种新型虚拟回肠造瘘装置，探讨其在预防传统虚拟回肠造瘘肠管、腹壁间粘连中作用。方法选取体重为2．5—3奴的成年健康家兔24只，分为3组每组8只：对照组（C组）、传统虚拟回肠造瘘组（T组）、虚拟回肠造瘘保护装置组（S组）。C组右中腹脐下约1cm经腹直肌纵切口长约3cm，切开腹壁逐层后腹腔不做特殊处理后关腹。T组开腹后将末端回肠硅胶环固定预置于皮下。S组开腹后使用新型回肠虚拟保护装置将末端回肠固定预置于皮下。术后14d处死动物，应用SPSS18．0统计软件分析，腹腔组织粘连评分、肠管组织纤维化、炎症反应、血管增生评分情况、肠段羟脯氨酸含量计量资料以均数±标准差（x±s）表示，全部组间比较采用单因素方差分析。P〈0．05为有统计学意义。结果s组粘连评分（1．25±0．89）较T组（3．00±0．76）明显降低（F=40．16，P=0．003），S组肠管纤维化、血管增生评分（1．50±0．53，1．25±0．46），较T组（2．25±0．89，1．88±0．64）明显降低（F=7．281，13．093，P=0．037，0．025），组间评分差异有统计学意义。炎症反应评分（1．52±0．53）较T组（1．75±0．71）稍有降低（F=2．078，P=0．392）。羟脯氨酸含量S组（1．99±0．76）较T组（4．18±0．52）明显降低（F=4．399，P=0．037），差异有统计学意义。结论新型虚拟回肠造瘘保护装置能够有效预防传统虚拟回肠造瘘所导致的肠管、腹壁间粘连，具有良好的临床应用前景。Objectives To design a new protective device of virtual ileostomy in rabbits for the prevention of intestinal adhesion caused by traditional virtual ileostomy. Methods A total of 24 adult rabbits weighing 2.5 - 3 kg were divided into three groups ： control （ C ） group （ n = 8 ）, traditional virtual ileostomy （T） group （n = 8 ）, and virtual ileostomy with protective device（S） group （n = 8 ）. In group C, a 3-cm trans-rectus-abdominis incision was made at the right low abdominal wall about 1 cm below the umbilicus, and open-close operation was done. In group T, the ileum was placed subcutaneously and supported by a latex ring. In group S, the ileum was fixed with the protective device. On POD14, rabbits were sacrificed. Statistical analysis was performed by using the SPSS 18.0 （SPSS, Inc, Chicago, IL, USA）. Score of adhesions, fibroblastic activity, vascular proliferation, information and the concentration of hydroxyproline expressed as mean ±standard deviation were evaluated by using one way analysis of variance followed by Student＇s t test. P 〈 0.05 was considered statistically significant. Ressults Less adhesion from gross appearance and lower Blauer and Collins scores （ 1.25 ± 0.89 ） were seen in Group S than （ 3.00± 0.76） in group T （F =40. 16, P =0. 003）. Total microscopic scores （fibroblastic activity and vascular proliferation）. were significantly lower in group S （ 1.50 ± 0. 53, 1.25 ±0.46 respectively） than in group T （2.25 ±0.89, 1.88 ±0.64 respectively） （ F = 7.281, 13. 093 respectively, P = 0. 037, 0. 025 ）. Total microscopic score of information was lower in group S （1.52±0.53） than in group T（ 1.75±0.71 ） （F =2. 078, P =0. 392）. The concentration of hydroxyproline was lower in group S （ 1.99 ±0.76 ） than in group T（4.18 ± 0.52 ） （ F = 4. 399, P = 0. 037）. Conclusion A new protective ileum loop appears to effectivelv prevent adhesions between the preplaced ileum loop and abdominal wall, with a favorable pro

关 键 词：动物实验 疾病模型 动物 直肠肿瘤 回肠造口术 黏连 

分 类 号：R735.37[医药卫生—肿瘤]